Electroconvulsive therapy (ECT) has been regarded as a somewhat
controversial treatment modality. Despite initial stigmatisation,
ECT has remained with us for the past 60 years and is
now emerging as a safe and effective treatment option.
<br>ECT is indicated in a wide range of disorders and is often
found to be of equal or even superior efficacy compared with
currently available pharmacological agents. However, it is not
without adverse effects and therefore a sound knowledge of
this treatment modality is crucial before its administration. The
clinician should have a thorough knowledge of indications,
method of administration, patient preparation, required seizure
duration, treatment course and side-effect profile.

Psychiatry has been practised in Australia in one form or
another since the peopling of the continent, originally with
the practices of the Aboriginal shamans, and later with the
psychiatric treatment necessitated by convict transportation.
<br>Over most of the last half-century psychiatry has been
administered by the Royal Australian and New Zealand
College of Psychiatrists.
<br>There are over 2 000 psychiatrists in Australia, and numbers
are expected to increase in future.
<br>As in many other countries, there is ongoing pressure
between the private and public sectors, with endemic underfunding
of public and community services.
<br>Despite its small number of practitioners and relative isolation
from major centres, Australian psychiatry has a distinguished
record in the field of research. The most famous discovery,
by John Cade, was the use of lithium for treatment of
mania.
<br>Recently governments at state and federal level have
acknowledged the effect of psychiatric illness on patients
and their families. This has led to the development of programmes
to improve public information and eliminate prejudice.
<br>It is anticipated that the practice of psychiatry will flourish in
Australia and that the country will remain a leading centre
of excellence in psychiatric research and training.